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Eur J Pediatr Surg 2010; 20(1): 29-34
DOI: 10.1055/s-0029-1241875
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of a Possible Inflammatory Response after Appendectomy for Non-Perforated Appendicitis in Children

F. Serour1 , 2 , A. Herman2 , I. Babai3 , A. Gorenstein1 , 2 , N. Gershon1 , E. Somekh4 , 2 , I. Dalal4 , 2
  • 1The E. Wolfson Medical center, Department of Pediatric Surgery, Holon, Israel
  • 2Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 3The E. Wolfson Medical Center, Clinical Immunology Laboratory, Holon, Israel
  • 4The E. Wolfson Medical Center, Pediatric Infectious/Allergy/Immunology Unit, Holon, Israel
Further Information

Publication History

received September 04, 2009

accepted after revision September 06, 2009

Publication Date:
28 October 2009 (online)

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Abstract

background: The inflammatory process in the post-appendectomy period is not well characterized. In a pilot study, we prospectively followed the kinetics of different inflammatory mediators before and after appendectomy in children, and compared the results of the groups open appendectomy (OA) and laparoscopic appendectomy (LA).

Material and Methods: Levels of sP-selectin, tPA, MCP-1, IL-6, IL-8, sVCAM-1, and sCD40L were measured before appendectomy and on the next three consecutive days in the serum of 25 children (16 males and 9 females) aged 7 – 16 years (mean 12.6±2.47 years) with non-perforated acute appendicitis.

Results: LA and OA were performed in 16 and 9 patients respectively. None of the markers of inflammation differed significantly by surgical approach at any point of observation. However, sP-selectin, MCP-1 and sVCAM-1 levels were found to have significantly different postoperative kinetics with a trend towards higher values in the laparoscopic group compared to the open appendectomy group (p=0.034, p=0.016 and p=0.025, respectively).

Conclusions: The cytokines sP-selectin, MCP-1 and sVCAM-1 may play a role in the possible post-appendectomy cytokine activation after non-perforated appendicitis. Since this phenomenon is more evident after LA than after OA, the contribution of the different LA procedures has to be further investigated.

Key words

appendicitis - children - cytokines - inflammation - laparoscopic appendectomy

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Correspondence

Dr. Francis SerourMD 

The E. Wolfson Medical center

Department of Pediatric Surgery

62 Halokhamim Street

58100 Holon

Israel

Phone: +97/235/02 84 19

Fax: +97/235/02 81 86

Email: serour@wolfson.health.gov.il